关节镜辅助带袢钢板悬吊固定术治疗后交叉韧带胫骨止点撕脱骨折对患者膝关节功能的影响

Effects of arthroscopic-assisted TightRope internal fixation on knee function in patients with tibial avulsion fracture at the posterior cruciate ligament attachment

摘要:

目的 探讨关节镜辅助带袢钢板悬吊固定术（TightRope系统）对后交叉韧带胫骨止点撕脱骨折患者膝关节功能、围手术期恢复及并发症的影响。方法 回顾性分析2022年1月—2025年3月华北医疗健康集团峰峰总医院邯郸院区收治的86例PCL胫骨止点撕脱骨折患者的临床资料，按治疗方式分为对照组和观察组，各43例。对照组采用切开复位内固定术治疗，观察组采用关节镜辅助带袢钢板悬吊固定术治疗。比较两组患者围手术期指标，治疗前后不同时间点膝关节活动度，治疗前后Lysholm膝关节功能评分（Lysholm）、国际膝关节文献委员会膝关节功能评分（IKDC），治疗前后视觉模拟评分法（VAS）评分，以及并发症发生情况。结果 与对照组比较，观察组的手术时间更短，术中出血量更少，切口长度更短（P <0.05）。观察组与对照组患者术前、术后1、3、6个月、1年膝关节活动度比较，不同时间点膝关节活动度比较，差异有统计学意义（P <0.05）；两组患者膝关节活动度比较，差异有统计学意义（P <0.05），观察组膝关节活动度更优；两组膝关节活动度变化趋势比较，差异有统计学意义（P <0.05）。观察组术后1年疼痛、稳定性、肿胀、上下楼梯、蹲姿、使用支撑物评分及Lysholm总分均高于对照组（P <0.05），IKDC评分高于对照组（P <0.05）。观察组术后1年VAS评分低于对照组（P <0.05）。两组并发症总发生率比较，差异无统计学意义（P >0.05）。结论 关节镜辅助带袢钢板悬吊固定术（TightRope系统）用于PCL胫骨止点撕脱骨折治疗，可优化围手术期恢复指标，减轻疼痛、促进膝关节活动度及功能恢复，并发症经针对性处理可有效控制，疗效优于传统切开复位内固定。

Abstract:

Objective To investigate the effect of arthroscopic-assisted TightRope suspension fixation on knee function, perioperative recovery, and complications in patients with tibial avulsion fracture at the posterior cruciate ligament (PCL) attachment.Methods A retrospective analysis was conducted on 86 patients diagnosed with PCL tibial avulsion fracture between January 2022 and March 2025. These patients were assigned to two groups, with 43 cases in each group. The control group received conventional open reduction and internal fixation, while the observation group received arthroscopic-assisted TightRope suspension fixation. Perioperative indicators, knee range of motion at preoperative and at 1, 3, 6, and 12 months postoperatively, Lysholm knee scores, International Knee Documentation Committee (IKDC) scores, visual analogue scale (VAS) pain scores, and complication rates were compared between the two groups.Results The observation group showed shorter operation time, less intraoperative blood loss, and smaller incision length than the control group (all P < 0.05). The observation group presented greater knee range of motion than the control group at 1, 3, and 6 months postoperatively (P < 0.05). At 1 year after surgery, the observation group achieved higher scores in pain, stability, swelling, stair climbing, squatting, support device use, total Lysholm score, and IKDC score, and lower VAS score than the control group (all P < 0.05). There was no statistically significant difference in the overall incidence of complications between the two groups (P > 0.05). All complications achieved effective clinical control after targeted treatment.Conclusion Arthroscopic-assisted TightRope suspension fixation for PCL tibial avulsion fracture improves perioperative parameters, relieves pain, promotes knee range of motion and functional recovery, and achieves effective control of complications with targeted treatment. It demonstrates superior efficacy compared with conventional open reduction and internal fixation.